Unpacking weight management interventions measuring eating disorder risk in adults: coding of components of interventions in a systematic review
Year: 2026
Type: review
Study design: Systematic Review
Abstract: INTRODUCTION: Adult weight management interventions are complex; better understanding of the intervention components that may impact eating disorder (ED) risk is required. METHODS: Weight management randomized controlled trials (RCTs) for adults with overweight/obesity that measured ED risk were systematically searched in four databases and two trial registries. A project-specific codebook was used to code 84 delivery features and 89 intervention strategies of trials. Individual strategies were grouped into 20 clusters which were further grouped into five broad categories. Trial investigators verified coding and narrative synthesis using descriptive statistics of findings was reported. RESULTS: Of 14,880 identified, 58 eligible trials were coded, of which 26 trials with 64 intervention arms were verified and therefore included. Intervention arms included a mean (SD) of 24 (11) intervention strategies. Commonly used intervention strategy clusters were nutrition education (91%), dietary behavior change strategies (84%), physical activity education (81%), and dietary self-monitoring (80%). Few interventions used strategies in the category of psychological components (13-41%). The median (range) intervention duration was 27 (4-104) weeks, and contacts with participants typically included a staged approach of weekly to monthly contact. CONCLUSION: Adult weight management interventions are multifactorial with varying delivery features and intervention strategies. Despite this, psychological (e.g. weight stigma) and sleep-health related strategies are either rarely used or are underreported. Breaking down intervention components using our framework can help identify which strategies influence outcomes, including eating disorder risk, and inform the design and reporting of future interventions. Some adults seeking weight management for obesity may have an eating disorder or disordered eating behaviors. Research shows most people who take part in behavioral weight management programs have an improvement in eating disorder symptoms, however a small number may experience worsening symptoms. In this study, we break down behavioral weight management programs that measure eating disorder risk to better understand the features they use. We found that these programs vary widely in the number and type of strategies they use, as well as in how they are delivered, such as the length of the program. Strategies that focus on psychological factors (for example, addressing weight stigma) and sleep health were rarely used or reported. These findings are useful in guiding the design and reporting of future behavioral weight management programs. They can also be used in future research to determine which specific program features improve or worsen outcomes such as eating disorder risk.
Source: Journal of Eating Disorders
Authors: Natalie B. Lister, Rabia Khalid, Isabelle R. Jardine, Samantha Pryde, Hannah Melville, Anna L. Seidler, Kylie E. Hunter, Amy L. Ahern, Louise A. Baur, Caroline Braet, Sarah P. Garnett, Andrew J. Hill, Sarah Maguire, Dasha Nicholls, Susan J. Paxton, Milan K. Piya, Amanda Sainsbury, Katharine Steinbeck, Denise E. Wilfley, Kelly Cooper, Genevieve Dammery, Alicia M. Grunseit, Faith Anne N. Heeren, Rebecca A. Jones, Theodore K. Kyle, Fiona Quigley, Molly Robbins, Aviva H. Ariel-Donges, Rachel D. Barnes, Kristine Beaulieu, Kerri N. Boutelle, Simona Calugi, Kelly M. Carpenter, Hoi Lun Cheng, Riccardo Dalle Grave, Marcelo Demarzo, Dawn M. Eichen, Erin L. Glynn, Katrijn Houben, Corby K. Martin, Janell L. Mensinger, Jayanthi Raman, Kristin M. von Ranson, Hollie A. Raynor, Elizabeth Rieger, Eric Robinson, Vera Salvo, Nancy E. Sherwood, Sharon A. Simpson, Evelyn Smith, Rachael W. Taylor, Krista A. Varady, Victoria Whitelock, Brittany J. Johnson, Hiba Jebeile
Institutions: The University of Sydney, Children's Hospital at Westmead, Flinders University, Caring Futures Institute, Universitätsmedizin Rostock, National Health and Medical Research Council, University of Cambridge, MRC Epidemiology Unit, Ghent University, University of Leeds, National Institute for Health and Care Research, Imperial College London, La Trobe University, Camden and Campbelltown Hospitals, Western Sydney University, The University of Western Australia, Washington University in St. Louis, Wake Forest University, WW International, Inc. (United States), University of Ulster, Nova Southeastern University, University of Minnesota, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, University of California San Diego, Casa di Cura Villa Garda, Westmead Hospital, Universidade Federal de São Paulo, Maastricht University, Pennington Biomedical Research Center, University of Newcastle Australia, University of Calgary, University of Tennessee at Knoxville, Australian National University, University of Liverpool, University of Glasgow, Medical Research Council, University of Otago, University of Illinois Chicago, Cancer Research UK
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $2,190
Funders: Small Business Innovation Research, Washington University in St. Louis, Hospital Research Foundation, McMaster University, Cancer Research UK, National Institute for Health and Care Research, University of Sydney, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Conselho Nacional de Desenvolvimento Científico e Tecnológico, National Institutes of Health, Alberta Gambling Research Institute, University of Calgary, Medical Research Council, National Health and Medical Research Council, NIHR Imperial Biomedical Research Centre, NIHR Cambridge Biomedical Research Centre, National Center for Complementary and Integrative Health
Awards: G14010149, G1415270815, What, when, and how to treat adolescents with obesity: generating evidence for clinical dietetic practice, Complexity in Health, G2493601830, G2537968379, G3622668182, G4289704537, Mind/Body Stress management to improve outcomes in a workplace weight loss progra, Improving weight loss by intermittent use of very low energy diet: the TANGO Diet Trial (Temporary phases of Accelerated weight loss for Noticeably Greater Outcomes), Optimising metabolic and mental health in the management of adolescent obesity, G4527031694, G4655236649, G4753630297, Transforming the prevention and treatment of child and adolescent obesity, G4881316918, G5274634927, NextGen evidence synthesis to maximise data utility and improve health outcomes, Understanding the interplay between eating disorders and weight management therapy, G7069699392, Bringing fields together: Identifying individuals at risk of eating disorders in weight management programs, Optimising benefits and minimising potential harms of obesity treatments
OpenAlex ID: W7165046092
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